Preoperative Incidence of Penile Abnormalities Found During Preoperative Incidence of Penile Abnormalities Found During Voluntary Male Medical Circumcision in Swaziland Voluntary Male Medical Circumcision in Swaziland

Background: Circumcision has proven to be an effective procedure in reducing the transmission of HIV in Africa. The Luke Commission (TLC), a mobile hospital outreach, has acted upon this research by performing thousands of male circumcisions throughout rural Swaziland, the country with the highest rate of HIV in the world. As a result of limited healthcare access, penile abnormalities that would be diagnosed during genital health exams in developed coun-tries are often found and corrected during these procedures. The objective of the study was to evaluate the rates of penile abnormalities discovered and treated during voluntary male medical circumcisions performed in Swaziland. Methods: We assessed the rates of the penile abnormalities through a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by the Luke Commission during a period from June-August, 2014. The participants of the study consisted of uncircumcised males ages 4 to 65 years old who lived in remote rural communities throughout Swaziland and volunteered for the procedure. As part of the TLC protocol, nursing staff perform a preoperative examination and document all ﬁ ndings in an electronic database. The penile abnormalities documented and analyzed included: phimosis, paraphimo-sis, epispadias, hypospadias, ulcers, balanitis, torsion, and cases of adherent foreskin attached to glans. This information is added to a database that records procedure date, date of birth/age and HIV status. Findings: Out of 929 total circumcisions, there were 726 patients (78%) with phimosis, 25 (3%) with hypospadias, 359 (39%) with adherent foreskin attached to glans, and no patients with paraphi-mosis, epispadias, ulcers, balanitis,


Authors Authors
Anthony R. Oddo, Elizabeth Ruedrich, Christopher Zust, Lindsey Marugg, Echo VanderWal, Rebekah Sartori, and Mary C. McCarthy This abstract is available at CORE Scholar: https://corescholar.libraries.wright.edu/surg/729 Mobile Solution for Immunization (M-SIMU) study; a recently completed 152 village randomized controlled trial that employs short message system (SMS) reminders and mobile money incentives to improve pediatric immunization coverage and timeliness in rural western Kenya. Oftentimes, randomized controlled trials and public health programs move forward without receiving input from the community the intervention seeks to serve. Focus group discussions (FGDs) prior to a trial's implementation helps ensure the interventions are contextualized to local customs and culture.
Methods: FGD was conducted with three groups of mothers ranging from eight to 12. The FGD participant's opinions on timing, frequency, and content of SMS reminders, amount of incentives, in addition to other perceived challenges and barriers, were sought and integrated into the M-SIMU trial.
Findings: The FGD participants preferred that the SMS reminders for M-SIMU to be offered in multiple languages, personalized with the child's name to maximize the likelihood that the message is correctly relayed to the intended recipient, sent to caregivers 3 days and 1 day before their infant's scheduled vaccination date, include the study sponsor, and have local motivational sayings appended to the end of the reminder. Also, the amount of incentives was suggested to range from 50 to 300 Kenya Shillings (USD 0.5 to 3).
Interpretation: The findings were incorporated in the M-SIMU study's design and during the conduct of the study; efficacy of the design was evidential. Improvements in vaccine coverage and timeliness were reported by various health stakeholders in the study area, including Community Health Workers (CHWs), Village Reporters (VRs) and nurses. Such success could be associated with the involvement of the key stakeholders (mothers) in designing the randomized controlled trial.
Funding: This is part of the M-SIMU study that was funded by the Bill and Melinda Gates Foundation. Background: Circumcision has proven to be an effective procedure in reducing the transmission of HIV in Africa. The Luke Commission (TLC), a mobile hospital outreach, has acted upon this research by performing thousands of male circumcisions throughout rural Swaziland, the country with the highest rate of HIV in the world. As a result of limited healthcare access, penile abnormalities that would be diagnosed during genital health exams in developed countries are often found and corrected during these procedures. The objective of the study was to evaluate the rates of penile abnormalities discovered and treated during voluntary male medical circumcisions performed in Swaziland.

Methods:
We assessed the rates of the penile abnormalities through a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by the Luke Commission during a period from June-August, 2014. The participants of the study consisted of uncircumcised males ages 4 to 65 years old who lived in remote rural communities throughout Swaziland and volunteered for the procedure. As part of the TLC protocol, nursing staff perform a preoperative examination and document all findings in an electronic database. The penile abnormalities documented and analyzed included: phimosis, paraphimosis, epispadias, hypospadias, ulcers, balanitis, torsion, and cases of adherent foreskin attached to glans. This information is added to a database that records procedure date, date of birth/age and HIV status.
Interpretation: These results display that a significant majority of patients had penile abnormalities that persisted well into their teenage years. This data exemplifies the steps The Luke Commission is taking alongside the Swaziland government towards decreasing HIV transmission and improving male sexual health.
Abstract #: 2.042_NEP Lived experience of persons with prostate cancer enrolled into palliative care: A qualitative study at mobile hospice Mbarara

A.O. Olirus; Mbarara University of Science and Technology, Uganda
Background: About 1 in 6 men worldwide will be diagnosed with prostate cancer during their lifetime. In Uganda, prostate cancer is currently one of the most common cancers among men with an age-standardized incidence rate of 39.6 per 100,000. Its physical, emotional and social effects greatly impacts the lives of men. Although current palliative care management practices are aimed at improving the quality of life, little has been documented on the lived experiences of men with prostate cancer in Uganda. This study explored the experiences of men with prostate cancer enrolled into palliative care in rural southwestern Uganda.
Methods: An exploratory study was conducted among 8 prostate cancer patients enrolled into palliative care in Mbarara district, southwestern Uganda. Data was collected between March and April 2015. Data obtained was analyzed using Colaizzi phenomenological approach along key themes; family and social relationships, spiritual life, care and treatment before palliative care and care at hospice.
Findings: The five key themes generated different subthemes with some reported examples from participants. Family relationship: subthemes; Good family relationship, "I would not be surviving if not for this family of mine"; lost functionality, "I feel uncomfortable for not being able to do anything as a man"; Feeling of hopelessness, "this disease made me lose my manhood!" Social relationships: subtheme; Good social support, "this sickness created for me very